This paper reviews the developmental history of Synanon Foundation Inc. from its inception in 1958 as an Alcoholics Anonymous alternative through its three transformations into a therapeutic community, an alternative society, and finally into a religion. That explanation rests on an understanding of Synanon's three transformations as strategic moves of organizational management to expand, solidify and consolidate control of the group.

Synanon argued that addiction, as just one of many “life-controlling issues,” required mutual discipline and containment. The article affirms members' and critics' description of the group as a cult that incarcerated its members and designed rituals to hurt them. Synanon's open embrace of religious brainwashing, as an applied fantasy supported by the state, had wide implications for the history of drug rehabilitation in the United States and for the use of the word “cult”.

Dederich's program featured a technique called the Synanon Game, which was an extreme version of group therapy. LIFE described it as “a dozen or so persons seated in a circle, telling the truth about each other, interrelating. Verbally, anything goes and the games are sometimes brutal, although never physically violent.”

Members met in a small storefront to play “The Game,” a verbal exercise where anyone was allowed to say anything to debunk excuses given by addicts for their addictions. “Anything” could include mockery and degradation. Members were brainwashed, mentally tortured, and barred from leaving.

This form of manipulation would become known as The Game. Outside of “game” sessions, Synanon members were required to be polite and civil with each other. However, inside these sessions they were encouraged to use profane language and be as critical as possible of their friends and fellow community members. No one deserves to endure this amount of ridicule and shame in their lives.

In Synanon, members were required to take part in a practice known as “The Game.” The Game is what is commonly seen as the beginnings of “attack therapy” – where one member would be forced to talk about themselves and endure harsh criticisms by their peers. The Game was often used to pressure members to submit to Dederich's will – including having members abort pregnancies, undergoing vasectomies, and commit violence. Music, guided mediation, sleep deprivation, and The Game was used throughout the weekend retreat to break people down.

Founded in 1958, Synanon sold itself as a cure for hardcore heroin addicts who could help each other by “breaking” new initiates with isolation, humiliation, hard labor, and sleep deprivation. Studies found that Synanon's “encounter groups” could produce lasting psychological harm and that only 10 to 15 percent of the addicts who participated in them recovered.

An essential component of this community was a cathartic screaming session known as "the game," during which members shouted and berated each other until the targeted member broke down and experienced an epiphany or revelation of personal growth. What began as a safe haven for a life-long recovery program for drug addicts became a controlled prison of sorts with cult practices and brainwashing programming.

The documentary is woven together using extensive archival material — including news reports and visceral footage of members playing “The Game,” in which participants were aggressively pushed to be brutally honest about themselves and each other. The group, named Synanon, expanded across the country and evolved into a self-help movement with thousands of members, including many who were not addicts but were simply drawn to its idealistic vision — no drugs, alcohol, or violence — and its primary ritual, an intensely confrontational form of group therapy known as “The Game.”

The cornerstone of Synanon's approach was a kind of confrontational group therapy called “the Synanon game,” in which participants would scream what they really thought of one another—and then hug it out afterwards. What happens when a rehab program that is supposed to cure addictions becomes addictive itself? That's the story of Synanon, an organization that went from providing revolutionary therapy to becoming “a kooky cult,” as TIME put it in 1977.

What he offered as “treatment” was called The Game, extended periods of direct verbal confrontation with the other residents, the philosophy being that addicts were unable to access emotions and turned to drugs to numb their feelings of rage, fear, despair, and so on. As Synanon grew and fell away from its original mission, it became vulnerable to pushback, particularly in the form of a 1972 San Francisco Examiner exposé that asserted that virtually no addicts were being treated and that the entire operation was a scam to separate well-meaning people from their money.

One of the most distinguishing practices of the Synanon community was a therapeutic practice commonly referred to as "The Game". The Game was a session during which one member would talk about themselves and then endure intense criticism by their peers. The "Game" was presented as a therapeutic tool, and likened to a form of group therapy; but it has been criticized as a form of a "social control", in which members humiliated one another and encouraged the exposure of one another's innermost weaknesses.